Top

Published in:

01-03-2016 | Clinical Article - Vascular

Outcomes in meningitis/ventriculitis treated with intravenous or intraventricular plus intravenous colistin

Authors: George Fotakopoulos, Demosthenes Makris, Maria Chatzi, Eleni Tsimitrea, Epaminondas Zakynthinos, Kostas Fountas

Published in: Acta Neurochirurgica | Issue 3/2016

Abstract

Background

The aim of this work is to evaluate the outcome of patients treated with intrathecal colistin for meningitis/ventriculitis.

Methods

This retrospective case series study included patients presenting with nosocomial meningitis/ventriculitis following neurosurgical interventions and having intravenous (IVC group) or intravenous and intrathecal/intraventricular colistin (ITC group) treatment between 2006 and 2014.

Results

Thirty-four patients presented nosocomial meningitis/ventriculitis; 11 (32.5 %) were included in the IVC group and 23 (67.6 %) in the ITC group. The most frequent isolated bacteria were Acinetobacter baumannii. The mean dose was 170,000 (±400) IU and the duration of intraventricular treatment was 16.0 (±8.3) days. The duration of intravenous treatment was 16.0 (±8.3) days in the ITC group and 15.3 ± 7.6 days in IVC group. Hospital mortality was significantly lower in the ITC group compared with the IVC group (13 vs. 72.7 %, p = 0.001).

Conclusions

The combination of intravenous plus intraventricular (IV-IVT) colistin therapy may improve outcomes in patients attending with meningitis/ventriculitis due to multi-drug resistance infections.

Available only for authorised users

Alfahad WA, Omrani AS (2014) Update on colistin in clinical practice. Saudi Med J 35(1):9–19PubMed

Baiocchi M, Catena V, Zago S, Badolati L, Baccarin M (2010) Intrathecal colistin for treatment of multidrug resistant (MDR) Pseudomonas aeruginosa after neurosurgical ventriculitis. Infez Med 18(3):182–6PubMed

Bargiacchi O, Rossati A, Car P, Brustia D, Brondolo R, Rosa F, Garavelli PL, De Rosa FG (2014) Intrathecal/intraventricular colistin in external ventricular device-related infections by multi-drug resistant Gram-negative bacteria: case reports and review. Infection 42(5):801–9CrossRefPubMed

Blount JP, Campbell JA, Haines SJ (1993) Complications in ventricular cerebrospinal fluid shunting. Neurosurg Clin N Am 4:633–656PubMed

Camacho EF, Boszczowski I, Basso M, Jeng BC, Freire MP, Guimarães T, Teixeira MJ, Costa SF (2011) Infection rate and risk factors associated with infections related to external ventricular drain. Infection 39(1):47–51CrossRefPubMed

Cascio A, Conti A, Sinardi L, Iaria C, Angileri FF, Stassi G, David T, Versaci A, Iaria M, David A (2010) Post-neurosurgical multidrug-resistant Acinetobacter baumannii meningitis successfully treated with intrathecal colistin. A new case and a systematic review of the literature. Int J Infect Dis 14(7):e572–9CrossRefPubMed

Chatzi M, Karvouniaris M, Makris D, Tsimitrea E, Gatos C, Tasiou A, Mantzarlis K, Fountas KN, Zakynthinos E (2014) Bundle of measures for external cerebral ventricular drainage-associated ventriculitis. Crit Care Med 42(1):66–73CrossRefPubMed

De Bonis P, Lofrese G, Scoppettuolo G, Spanu T, Cultrera R, Labonia M, Cavallo MA, Mangiola A, Anile C, Pompucci A (2015) Intraventricular versus intravenous colistin for the treatment of extensively drug-resistant Acinetobacter baumannii meningitis. Eur J Neurol 31

Faillace WJ (1995) A no-touch technique protocol to diminish cerebrospinal fluid shunt infection. Surg Neurol 43:344–350CrossRefPubMed

10.

Falagas MSKK (2006) Toxicity of polymyxins: a systematic review of the evidence from old and recent studies. Crit Care 10:R27PubMedCentralCrossRefPubMed

11.

Falagas ME, Kasiakou SK (2006) Use of international units when dosing colistin will help decrease confusion related to various formulations of the drug around the world. Antimicrob Agents Chemother 50:2274–2275PubMedCentralCrossRefPubMed

12.

Fernandez-Viladrich P, Corbella X, Corral L, Tubau F, Mateu A (1999) Successful treatment of ventriculitis due to carbapenem-resistant Acinetobacter baumannii with intraventricular colistin sulfomethate sodium. Clin Infect Dis 28:916–7CrossRefPubMed

13.

Gobin P, Lemaître F, Marchand S, Couet W, Olivier JC (2010) Assay of colistin and colistin methanesulfonate in plasma and urine by liquid chromatography-tandem mass spectrometry. Antimicrob Agents Chemother 54(5):1941–8PubMedCentralCrossRefPubMed

14.

Goodwin NJ (1969) Colistin sulfate versus sodium colistimethate. Ann Intern Med 70(1):232–3CrossRefPubMed

15.

Henwood CJ, Gatward T, Warner M et al (2002) Antibiotic resistance among clinical isolates of Acinetobacter in the UK, and in vitro evaluation of tigecycline (GAR-936). J Antimicrob Chemother 49:479–87CrossRefPubMed

16.

Hoeprich PD (1970) The polymyxins. Med Clin North Am 54:1257–65PubMed

17.

Karaiskos I, Galani L, Baziaka F, Giamarellou H (2013) Intraventricular and intrathecal colistin as the last therapeutic resort for the treatment of multidrug-resistant and extensively drug-resistant Acinetobacter baumannii ventriculitis and meningitis: a literature review. Int J Antimicrob Agents 41(6):499–508CrossRefPubMed

18.

Katragkou A, Roilides E (2005) Successful treatment of multi drug-resistant Acinetobacter baumannii central nervous system infections with colistin. J Clin Microbiol 43:4916–4917PubMedCentralCrossRefPubMed

19.

Khawcharoenporn T, Apisarnthanarak A, Mundy LM (2010) Intrathecal colistin for drug-resistant Acinetobacter baumannii central nervous system infection: a case series and systematic review. Clin Microbiol Infect 16(7):888–94CrossRefPubMed

20.

Kim BN, Peleg AY, Lodise TP, Lipman J, Li J, Nation R, Paterson DL (2009) Management of meningitis due to antibiotic-resistant Acinetobacter species. Lancet Infect Dis 9(4):245–55PubMedCentralCrossRefPubMed

21.

Koch-Weser J, Sidel VW, Federman EB, Kanarek P, Finer DC, Eaton AE (1970) Adverse effects of sodium colistimethate. Manifestations and specific reaction rates during 317 courses of therapy. Ann Intern Med 72:857–868CrossRefPubMed

22.

Li J, Nation RL, Turnidge JD, Milne RW, Coulthard K, Rayner CR, Paterson DL (2006) Colistin: the reemerging antibiotic for multidrug-resistant Gram-negative bacterial infections. Lancet Infect Dis 6:589–601CrossRefPubMed

23.

Lozier AP, Sciacca RR, Romagnoli MF, Connolly ES Jr (2008) Ventriculostomy-related infections: a critical review of the literature. Neurosurgery 62:688–700CrossRefPubMed

24.

Markantonis SL, Markou N, Fousteri M, Sakellaridis N, Karatzas S, Alamanos I, Dimopoulou E, Baltopoulos G (2009) Penetration of colistin into cerebrospinal fluid. Antimicrob Agents Chemother 53:4907–4910PubMedCentralCrossRefPubMed

25.

McClelland S 3rd, Hall WA (2007) Postoperative central nervous system infection: incidence and associated factors in 2111 neurosurgical procedures. Clin Infect Dis 45:55–59CrossRefPubMed

26.

McGirt MJ, Zaas A, Fuchs HE, George TM, Kaye K, Sexton DJ (2003) Risk factors for pediatric ventriculoperitoneal shunt infection and predictors of infectious pathogens. Clin Infect Dis 36:858–862CrossRefPubMed

27.

Munoz-Price LS, Weinstein RA (2008) Acinetobacter infection. N Engl J Med 20;358(12):1271-81. Review

28.

Nation RL, Li J, Cars O, Couet W, Dudley MN, Kaye KS, Mouton JM, Paterson DL, Tam VH, Theuretzbacher U, Tsuji BT, Turnidje JD (2013) Consistent global approach on reporting of colistin doses to promote safe and effective use. Clin Infect Dis 58:139–141CrossRefPubMed

29.

Ng J, Gosbell IB, Kelly JA, Boyle MJ, Ferguson JK (2006) Cure of multiresistant Acinetobacter baumannii central nervous system infections with intraventricular or intrathecal colistin: case series and literature review. J Antimicrob Chemother 58(5):1078–81CrossRefPubMed

30.

Nseir S, Favory R, Jozefowicz E, Decamps F, Dewavrin F, Brunin G, Di Pompeo C, Mathieu D, Durocher A (2008) VAT Study Group. Antimicrobial treatment for ventilator-associated tracheobronchitis: a randomized, controlled, multicenter study. Crit Care 12(3):R62PubMedCentralCrossRefPubMed

31.

Remeš F, Tomáš R, Jindrák V, Vaniš V, Setlík M (2013) Intraventricular and lumbar intrathecal administration of antibiotics in postneurosurgical patients with meningitis and/or ventriculitis in a serious clinical state. J Neurosurg 119(6):1596–602CrossRefPubMed

32.

Rodriguez Guardado A, Blanco A, Asensi V, Pérez F, Rial JC, Pintado V, Bustillo E, Lantero M, Tenza E, Alvarez M, Maradona JA, Carton JA (2008) Multidrug-resistant Acinetobacter meningitis in neurosurgical patients with intraventricular catheters: assessment of different treatments. J Antimicrob Chemother 61(4):908–13CrossRefPubMed

33.

Scheithauer S, Bürgel U, Ryang YM, Haase G, Schiefer J, Koch S, Häfner H, Lemmen S (2009) Prospective surveillance of drain associated meningitis/ventriculitis in a neurosurgery and neurological intensive care unit. Neurol Neurosurg Psychiatry 80(12):1381–5CrossRef

34.

Laxmi S, Tunkel AR (2011) Healthcare-associated bacterial meningitis. Curr Infect Dis Rep 13:367–373CrossRefPubMed

35.

Stenehjem E, Armstrong WS (2012) Central nervous system device infections. Infect Dis Clin North Am 26:89–110CrossRefPubMed

36.

Tunkel AR, Hartman BJ, Kaplan SL, Kaufman BA, Roos KL, Scheld WM, Whitley RJ (2004) Practice guidelines for the management of bacterial meningitis. Clin Infect Dis 39:1267–84CrossRefPubMed

37.

Vicari G, Bauer SR, Neuner EA, Lam SW (2013) Association between colistin dose and microbiologic outcomes in patients with multidrug-resistant Gram-negative bacteremia. Clin Infect Dis 56:398–404CrossRefPubMed

38.

Vincent JL, Rello J, Marshall J, Silva E, Anzueto A, Martin CD, Moreno R, Lipman J, Gomersall C, Sakr Y, Reinhart K (2009) EPIC II group of investigators. International study of the prevalence and outcomes of infection in intensive care units. JAMA 302:2323–9CrossRefPubMed

39.

Wang JH, Lin PC, Chou CH, Ho CM, Lin KH, Tsai CT, Wang JH, Chi CY, Ho MW (2014) Intraventricular antimicrobial therapy in postneurosurgical Gram-negative bacillary meningitis or ventriculitis: a hospital-based retrospective study. J Microbiol Immunol Infect 47(3):204–10CrossRefPubMed

40.

Ziaka M, Markantonis SL, Fousteri M, Zygoulis P, Panidis D, Karvouniaris M, Makris D, Zakynthinos E (2013) Combined intravenous and intraventricular administration of colistin methanesulfonate in critically ill patients with central nervous system infection. Antimicrob Agents Chemother 57(4):1938–40PubMedCentralCrossRefPubMed

Title: Outcomes in meningitis/ventriculitis treated with intravenous or intraventricular plus intravenous colistin
Authors: George Fotakopoulos
Demosthenes Makris
Maria Chatzi
Eleni Tsimitrea
Epaminondas Zakynthinos
Kostas Fountas
Publication date: 01-03-2016
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 3/2016
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-016-2702-y

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Outcomes in meningitis/ventriculitis treated with intravenous or intraventricular plus intravenous colistin

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2016

Somatostatin treatment can induce extensive fibrosis in growth hormone-producing adenoma

Parasitic twin—a supernumerary limb associated with spinal malformations. A case report

Laligam Sekhar, Richard G. Fessler: Atlas of neurosurgical techniques: brain, second edition, two volume set

Erratum to: Intraforaminal ozone therapy

Major recanalization occurs more often in young patients after unruptured aneurysm coil embolization

Trigeminal and sphenopalatine ganglion stimulation for intractable craniofacial pain—case series and literature review